title: Varicocele treatment: a 2-centers comparison between non microsurgical open correction, laparoscopic approach and retrograde percutaneous sclerotization on 463 cases.
abstract: OBJECTIVE
  To determine whether there are differences in sperm parameters improvement after different varicocele correction techniques. To determine the role of age in sperm parameters improvement.
  
  
  METHODS
  2 different European centers collected pre- and postoperative sperm parameters of patients undergoing varicocele correction. Among 463 evaluated patients, 367 were included. Patients were divided in procedure-related and age-related groups. Ivanissevich inguinal open surgical procedure (OS), lymphatic-sparing laparoscopic approach (LSL) and retrograde percutaneous transfemoral sclerotization (RPS) were performed. As outcome measurements sperm count (millions/mL, SC) and percentage of mobile sperms were analyzed. Univariate and multivariate regression between the defined groups; bivariate regression analysis between age and sperm count and motility.
  
  
  RESULTS
  Number of patients: OS 78; LSL 85; RPS 204. Mean age 30.2 (SD 6.83); postoperative SC increased from 18.2 to 30.1 (CI 95% 27.3-32.9; p < 0,001); motility from 25.6 to 32.56% (30.9-34.2; p < 0.001). OS: SC varied from 16.9 to 18.2 (p < 0.001); sperm motility from 29% to 33% (p < 0.001). LSL: SC from 15.5 to 17.2 (p < 0.001); motility from 27 to 31% (p < 0.001). RPS: SC from 18.9 to 36.2 (p < 0.001); motility from 24% to 32% (p < 0.001). Univariate and multivariate analysis confirmed the significant difference of SC variation in RPS, compared to the other groups (p < 0.001). No significance between LSL and OS (p = 0.826). No significant differences regarding motility (p = 0.8).
  
  
  CONCLUSIONS
  Varicocele correction is confirmed useful in improving sperm parameters; sclerotization technique leads to a better sperm improvement compared to other studied procedures; improvement in seminal parameters is not affected by age of the patients treated.
authors.affiliation: Urologic Unit, Cattinara Hospital, University of Trieste, Trieste. g.ollandini@gmail.com.
authors.forename: Giangiacomo
authors.initials: G
authors.lastname: Ollandini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Liguori
authors.forename: Stanislav
authors.initials: S
authors.lastname: Ziaran
authors.forename: Tomáš
authors.initials: T
authors.lastname: Málek
authors.forename: Giorgio
authors.initials: G
authors.lastname: Mazzon
authors.forename: Bernardino
authors.initials: B
authors.lastname: de Concilio
authors.forename: Stefano
authors.initials: S
authors.lastname: Bucci
authors.forename: Sara
authors.initials: S
authors.lastname: Benvenuto
authors.forename: Emanuele
authors.initials: E
authors.lastname: Belgrano
authors.forename: Carlo
authors.initials: C
authors.lastname: Trombetta
mesh_terms: D000328:Adult; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008866:Microsurgery; D015911:Sclerotherapy / Q000379:methods; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014646:Varicocele / Q000601:surgery / Q000628:therapy*; D055815:Young Adult